| Code | Description | Claims | Beneficiaries | Total Paid |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
5,377 |
4,839 |
$3.63M |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
9,829 |
8,849 |
$3.29M |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
17,627 |
16,566 |
$2.91M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28,897 |
24,731 |
$1.07M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
31,473 |
25,444 |
$972K |
| G0378 |
Hospital observation service, per hour |
2,578 |
2,338 |
$730K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,011 |
1,881 |
$521K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,644 |
2,420 |
$358K |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
8,569 |
7,267 |
$348K |
| 80050 |
General health panel |
3,397 |
3,208 |
$345K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
5,396 |
5,112 |
$331K |
| 80053 |
Comprehensive metabolic panel |
29,825 |
23,754 |
$322K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,542 |
7,226 |
$302K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
1,975 |
1,854 |
$223K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
5,172 |
4,877 |
$222K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
5,394 |
5,111 |
$219K |
| 80061 |
Lipid panel |
8,565 |
8,349 |
$218K |
| 86703 |
|
4,515 |
4,378 |
$216K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
3,733 |
1,039 |
$204K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
32,034 |
24,469 |
$187K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
3,041 |
2,928 |
$172K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,147 |
2,062 |
$160K |
| T1015 |
Clinic visit/encounter, all-inclusive |
2,137 |
1,828 |
$149K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
590 |
552 |
$143K |
| 87081 |
|
6,494 |
6,226 |
$138K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,191 |
4,747 |
$134K |
| 96413 |
Chemotherapy administration, intravenous infusion; up to 1 hour, single or initial substance |
1,475 |
799 |
$130K |
| 82652 |
|
2,486 |
2,395 |
$119K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,602 |
1,543 |
$118K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
2,172 |
1,593 |
$115K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
8,664 |
8,352 |
$107K |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
1,988 |
1,320 |
$97K |
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
12,161 |
10,610 |
$95K |
| 87631 |
|
1,797 |
1,727 |
$94K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,524 |
1,400 |
$94K |
| 71045 |
Radiologic examination, chest; single view |
4,680 |
4,127 |
$93K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
5,881 |
4,023 |
$89K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
767 |
724 |
$86K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
11,617 |
5,634 |
$74K |
| 87276 |
|
7,841 |
7,472 |
$73K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
4,237 |
2,842 |
$68K |
| 71046 |
Radiologic examination, chest; 2 views |
2,618 |
2,440 |
$68K |
| 80055 |
|
378 |
367 |
$67K |
| 87275 |
|
7,846 |
7,478 |
$67K |
| Q3014 |
Telehealth originating site facility fee |
4,247 |
3,711 |
$65K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
423 |
403 |
$65K |
| 84484 |
|
5,822 |
4,161 |
$61K |
| 93307 |
|
551 |
523 |
$60K |
| 81001 |
|
12,203 |
10,846 |
$56K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
6,155 |
5,507 |
$55K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
4,712 |
2,998 |
$54K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
382 |
350 |
$54K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
866 |
768 |
$49K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,610 |
2,493 |
$46K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,427 |
987 |
$45K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
840 |
772 |
$39K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,975 |
1,892 |
$36K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
498 |
476 |
$35K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
506 |
454 |
$33K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
1,160 |
790 |
$32K |
| 82805 |
|
822 |
706 |
$30K |
| 84439 |
|
2,513 |
2,364 |
$27K |
| 76830 |
Ultrasound, transvaginal |
256 |
248 |
$27K |
| 81003 |
|
6,154 |
4,674 |
$26K |
| 96360 |
Intravenous infusion, hydration; initial, 31 minutes to 1 hour |
549 |
515 |
$26K |
| J1650 |
Injection, enoxaparin sodium, 10 mg |
3,246 |
1,255 |
$25K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,154 |
2,101 |
$25K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
845 |
838 |
$25K |
| 84703 |
|
3,414 |
3,075 |
$24K |
| 88164 |
|
1,357 |
1,317 |
$24K |
| 76801 |
|
277 |
256 |
$24K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
3,221 |
2,287 |
$24K |
| 96376 |
|
1,702 |
938 |
$23K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
518 |
260 |
$23K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
224 |
220 |
$23K |
| 82948 |
|
6,922 |
2,147 |
$22K |
| 97162 |
|
455 |
434 |
$22K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
738 |
723 |
$21K |
| 99281 |
Emergency department visit for the evaluation and management, self-limited or minor |
558 |
526 |
$21K |
| J0131 |
Injection, acetaminophen, not otherwise specified,10 mg |
1,497 |
1,292 |
$21K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,538 |
816 |
$21K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,319 |
3,233 |
$21K |
| 83880 |
|
1,002 |
925 |
$20K |
| 85610 |
|
4,363 |
3,697 |
$20K |
| 86850 |
|
1,785 |
1,583 |
$20K |
| 87430 |
|
2,413 |
2,322 |
$19K |
| 86803 |
|
2,269 |
2,216 |
$19K |
| 99070 |
|
67 |
66 |
$18K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,333 |
2,222 |
$17K |
| 76641 |
|
179 |
175 |
$17K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
182 |
174 |
$16K |
| 59025 |
Fetal non-stress test |
796 |
520 |
$16K |
| 83605 |
|
2,040 |
1,542 |
$15K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,845 |
1,635 |
$15K |
| 73560 |
|
603 |
508 |
$15K |
| 85730 |
|
2,306 |
2,022 |
$15K |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
4,320 |
3,374 |
$15K |
| J2270 |
Injection, morphine sulfate, up to 10 mg |
3,230 |
1,995 |
$15K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
81 |
75 |
$15K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
201 |
177 |
$14K |
| 0202U |
Oncology (prostate), multianalyte, gene expression profiling |
422 |
394 |
$14K |
| 83690 |
|
2,928 |
2,598 |
$13K |
| 81025 |
|
1,723 |
1,644 |
$13K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
3,085 |
2,590 |
$13K |
| 83735 |
|
3,081 |
1,947 |
$13K |
| 82570 |
|
3,560 |
3,432 |
$13K |
| 90715 |
|
807 |
770 |
$13K |
| 82043 |
|
3,191 |
3,106 |
$13K |
| 97163 |
|
257 |
251 |
$12K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
183 |
181 |
$12K |
| 73030 |
|
449 |
403 |
$12K |
| 72131 |
|
112 |
108 |
$12K |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
3,457 |
2,584 |
$11K |
| 86592 |
|
2,124 |
2,074 |
$11K |
| 82728 |
|
798 |
765 |
$11K |
| 96361 |
Intravenous infusion, hydration; each additional hour |
1,028 |
886 |
$11K |
| 82950 |
|
392 |
377 |
$11K |
| 86787 |
|
186 |
180 |
$10K |
| 87340 |
|
1,464 |
1,431 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
156 |
146 |
$10K |
| 87186 |
|
1,892 |
1,501 |
$9K |
| 99233 |
Prolong inpt eval add15 m |
237 |
104 |
$9K |
| 87077 |
|
2,039 |
1,644 |
$9K |
| 82607 |
|
923 |
885 |
$9K |
| 84702 |
|
898 |
753 |
$9K |
| 82330 |
|
1,114 |
967 |
$9K |
| 73130 |
|
246 |
213 |
$8K |
| 90651 |
|
90 |
84 |
$8K |
| 70498 |
|
49 |
42 |
$8K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
326 |
158 |
$8K |
| 87040 |
|
1,153 |
552 |
$7K |
| 72170 |
|
285 |
265 |
$7K |
| 72100 |
|
208 |
199 |
$7K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,053 |
755 |
$7K |
| 90461 |
|
2,846 |
2,116 |
$7K |
| J3490 |
Unclassified drugs |
728 |
393 |
$7K |
| 86140 |
|
1,639 |
1,213 |
$6K |
| 73630 |
|
229 |
198 |
$6K |
| 90686 |
|
2,689 |
2,503 |
$6K |
| 86900 |
|
2,227 |
2,008 |
$6K |
| 86901 |
|
2,223 |
2,005 |
$6K |
| 0124A |
|
167 |
149 |
$6K |
| 73610 |
|
128 |
112 |
$5K |
| 85651 |
|
1,547 |
1,265 |
$5K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
40 |
37 |
$4K |
| 85027 |
|
1,194 |
981 |
$4K |
| 96367 |
|
242 |
173 |
$4K |
| 84100 |
|
1,778 |
1,182 |
$4K |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,410 |
1,174 |
$4K |
| 82746 |
|
462 |
450 |
$4K |
| J1170 |
Injection, hydromorphone, up to 4 mg |
883 |
610 |
$4K |
| 84481 |
|
295 |
264 |
$4K |
| 97116 |
|
483 |
301 |
$4K |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
941 |
704 |
$4K |
| 90656 |
|
329 |
321 |
$4K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
12 |
12 |
$4K |
| J2469 |
Injection, palonosetron hcl, 25 mcg |
49 |
27 |
$4K |
| 83540 |
|
711 |
685 |
$3K |
| 72128 |
|
28 |
26 |
$3K |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
1,222 |
1,100 |
$3K |
| 87210 |
|
671 |
634 |
$3K |
| 73090 |
|
85 |
78 |
$3K |
| 99385 |
|
45 |
44 |
$3K |
| 73590 |
|
94 |
78 |
$3K |
| 97535 |
Self-care/home management training, each 15 minutes |
322 |
178 |
$3K |
| 93971 |
|
27 |
26 |
$3K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
106 |
106 |
$3K |
| 83970 |
|
125 |
124 |
$3K |
| 82947 |
|
1,137 |
1,044 |
$3K |
| 80074 |
|
113 |
110 |
$3K |
| 73110 |
|
79 |
65 |
$3K |
| 86480 |
|
26 |
25 |
$3K |
| 84295 |
|
904 |
804 |
$2K |
| G0402 |
Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment |
102 |
102 |
$2K |
| 87220 |
|
660 |
624 |
$2K |
| 84132 |
|
947 |
848 |
$2K |
| 83550 |
|
362 |
346 |
$2K |
| 70496 |
|
16 |
12 |
$2K |
| 97164 |
|
28 |
26 |
$2K |
| 99242 |
|
30 |
30 |
$2K |
| 82435 |
|
889 |
806 |
$2K |
| 87070 |
|
299 |
236 |
$2K |
| J2543 |
Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams) |
77 |
38 |
$2K |
| 77066 |
Tomosynthesis, mammo |
33 |
30 |
$2K |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
142 |
113 |
$2K |
| 94664 |
|
215 |
113 |
$2K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
109 |
106 |
$2K |
| J2704 |
Injection, propofol, 10 mg |
2,113 |
1,939 |
$2K |
| 84145 |
|
96 |
78 |
$1K |
| 90674 |
|
28 |
26 |
$1K |
| 82140 |
|
156 |
141 |
$1K |
| 82550 |
|
269 |
218 |
$1K |
| 80069 |
|
229 |
207 |
$1K |
| 70486 |
|
12 |
12 |
$1K |
| 99223 |
Prolong inpt eval add15 m |
13 |
12 |
$1K |
| 94760 |
|
197 |
91 |
$1K |
| 76000 |
|
27 |
25 |
$1K |
| 77080 |
|
79 |
79 |
$974.35 |
| J3370 |
Injection, vancomycin hcl, 500 mg |
16 |
12 |
$927.30 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
19 |
13 |
$917.09 |
| 36415 |
Collection of venous blood by venipuncture |
27,493 |
23,961 |
$909.68 |
| 91322 |
|
75 |
73 |
$846.33 |
| 76937 |
|
12 |
12 |
$823.39 |
| 99239 |
Hospital discharge day management, more than 30 minutes |
12 |
12 |
$815.66 |
| 0001A |
|
848 |
811 |
$788.55 |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
40 |
25 |
$734.61 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
86 |
80 |
$703.89 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
47 |
47 |
$695.15 |
| 83721 |
|
68 |
63 |
$694.42 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
27 |
27 |
$675.55 |
| A9270 |
Non-covered item or service |
1,149 |
499 |
$663.34 |
| 86038 |
|
66 |
65 |
$631.75 |
| 85018 |
|
287 |
207 |
$587.31 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
18 |
14 |
$513.22 |
| 83525 |
|
14 |
13 |
$491.36 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
26 |
16 |
$490.50 |
| 73080 |
|
14 |
13 |
$481.38 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
868 |
863 |
$470.42 |
| J2060 |
Injection, lorazepam, 2 mg |
112 |
83 |
$451.17 |
| J0137 |
Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg |
37 |
34 |
$442.82 |
| J1790 |
Injection, droperidol, up to 5 mg |
93 |
82 |
$397.60 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
44 |
40 |
$388.16 |
| 58300 |
|
12 |
12 |
$360.92 |
| J1940 |
Injection, furosemide, up to 20 mg |
32 |
15 |
$352.03 |
| 97597 |
|
62 |
25 |
$345.41 |
| S5551 |
Insulin, most rapid onset (lispro or aspart); 5 units |
89 |
39 |
$320.38 |
| 87205 |
|
123 |
100 |
$315.27 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
27 |
27 |
$313.88 |
| 84520 |
|
136 |
130 |
$305.08 |
| 99201 |
|
52 |
46 |
$299.51 |
| 90680 |
|
236 |
225 |
$269.08 |
| 85014 |
|
148 |
102 |
$259.88 |
| Q9950 |
Injection, sulfur hexafluoride lipid microspheres, per ml |
13 |
12 |
$232.44 |
| 86696 |
|
13 |
12 |
$212.88 |
| 90662 |
|
227 |
226 |
$209.30 |
| 90480 |
|
75 |
73 |
$204.60 |
| 0011A |
|
22 |
22 |
$200.00 |
| 88312 |
|
13 |
12 |
$175.80 |
| 80159 |
|
12 |
12 |
$169.30 |
| J0688 |
Injection, cefazolin sodium (hikma), not therapeutically equivalent to j0690, 500 mg |
81 |
65 |
$169.13 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
90 |
66 |
$167.46 |
| 0002A |
|
343 |
341 |
$156.78 |
| 86695 |
|
13 |
12 |
$145.14 |
| 84156 |
|
57 |
53 |
$142.74 |
| 80076 |
|
34 |
25 |
$140.34 |
| 82378 |
|
12 |
12 |
$135.72 |
| 84550 |
|
54 |
51 |
$130.48 |
| 85396 |
|
23 |
12 |
$112.60 |
| 83615 |
|
18 |
16 |
$111.18 |
| 84146 |
|
19 |
19 |
$106.15 |
| 82248 |
|
42 |
36 |
$95.91 |
| J1815 |
Injection, insulin, per 5 units |
892 |
253 |
$95.54 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
44 |
44 |
$93.26 |
| 0003A |
|
13 |
13 |
$91.13 |
| C1769 |
Guide wire |
17 |
13 |
$74.19 |
| 85007 |
|
31 |
25 |
$65.08 |
| 90756 |
|
29 |
26 |
$64.03 |
| 90694 |
|
157 |
144 |
$63.60 |
| 82150 |
|
12 |
12 |
$46.79 |
| 90633 |
|
207 |
186 |
$46.49 |
| 90670 |
|
742 |
612 |
$36.92 |
| 90677 |
|
139 |
132 |
$33.92 |
| 82270 |
|
12 |
12 |
$29.21 |
| G0009 |
Administration of pneumococcal vaccine |
24 |
24 |
$22.18 |
| G0008 |
Administration of influenza virus vaccine |
757 |
719 |
$10.46 |
| 91312 |
|
170 |
150 |
$0.23 |
| 91300 |
|
1,076 |
922 |
$0.13 |
| 91301 |
|
173 |
155 |
$0.09 |
| 90621 |
|
17 |
12 |
$0.01 |
| 90734 |
|
320 |
260 |
$0.00 |
| 90710 |
|
88 |
84 |
$0.00 |
| 1159F |
|
219 |
202 |
$0.00 |
| 1026F |
|
76 |
72 |
$0.00 |
| 3078F |
|
117 |
111 |
$0.00 |
| 1160F |
|
194 |
180 |
$0.00 |
| 90648 |
|
59 |
46 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
12 |
12 |
$0.00 |
| 90649 |
|
27 |
26 |
$0.00 |
| 3074F |
|
27 |
26 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,129 |
1,073 |
$0.00 |
| 1170F |
|
64 |
61 |
$0.00 |
| 1126F |
|
983 |
942 |
$0.00 |
| 90620 |
|
53 |
53 |
$0.00 |
| 2010F |
|
228 |
213 |
$0.00 |
| 90698 |
|
212 |
181 |
$0.00 |
| 90743 |
|
25 |
25 |
$0.00 |
| 99024 |
|
80 |
41 |
$0.00 |
| 3008F |
|
122 |
117 |
$0.00 |
| 4010F |
|
74 |
72 |
$0.00 |
| 90723 |
|
14 |
12 |
$0.00 |
| 3075F |
|
15 |
15 |
$0.00 |
| 3044F |
|
14 |
13 |
$0.00 |